NHS pay review body: twenty-sixth report 2012 - Official Documents

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Chapter 5 – General Workforce Issues Introduction 5.1 5.2 In addition to our remit for those AfC staff earning £21,000 or less, the Chief Secretary to the Treasury’s remit letter also confirmed that for those workers paid above £21,000 the UK Government would provide information about recruitment, retention and other aspects of the affected workforces as appropriate. We therefore review the information provided by the parties on the AfC workforce under the following headings: • • • • • • Trends in recruitment and retention; Morale and motivation; Workforce planning; Training and development; The Knowledge and Skills Framework; and Data relating to our remit group. Trends in Recruitment and Retention 5.3 We summarised the available evidence on recruitment and retention relating to those earning £21,000 or less in Chapter 3. From this evidence, we continue to conclude that overall for AfC staff the position on recruitment is healthy and retention is stable. In this section, we therefore review the information provided by the parties on training commissions and AfC shortage groups. Recruitment 5.4 The Staff Side pointed to an ageing profile of the NHS workforce in England which it suggested would be worth tracking to establish whether it represented a worrying trend for the NHS in attracting younger staff. They stated that an ageing workforce had long been apparent within nursing and midwifery. They highlighted that 12.8% of all nurses and health visitors were over the age of 55 in 2009. 5.5 5.6 The commissioning levels for non-medical groups within the NHS were set to “plummet” between 2010/11 and 2011/12, according to the evidence submitted by the Staff Side. Anticipated commissioning rates were well below recent levels for the majority of professions, with the exception of community nursing where the increase was almost entirely driven by the commitment to increasing the number of health visitors. The Staff Side believed a short term, cost-driven “slashing” of commissioned places across almost all occupations that require professional training was at the expense of long term medical needs. The Staff Side highlighted the decrease in the number of additions to the nursing workforce from outside the EU. This had occurred while there was a simultaneous increase in UK nurses migrating to work abroad. The 5.7 Department of Health reported on training commissions. The two routes into nursing had seen a switch from diploma to degree commissions and therefore there had been a rise in degree commissions and a reduction in diploma commissions by 2010/11. The Department also reported on the decrease in training commissions for allied health 57
58 professionals and healthcare scientists and technicians. However, the Department commented that, while the intake to training places was important, the key driver for future supply was the output from programmes which varied with student retention. The Department added that the number of training places to commission was, therefore, based on anticipated demand in the local health economy, recent information about student retention and levels of graduate employment. Our Comment 5.8 We note that there is a planned drop in number of training commissions and we comment later in this chapter about our concerns over the fragmentation of the workforce planning process. While we also note that overall non-medical workforce numbers are planned to decline slightly, in our view such falls in the number of training commissions can store up potential manpower supply problems which only become evident in the future. In such cases it can be difficult to redress such shortages in supply and they can often lead to expensive pay solutions to retain experienced staff. We ask the parties to continue to monitor the number of training commissions for our remit group and report any concerns in future evidence. AfC Shortage Groups 5.9 5.10 5.11 5.12 1 The Migration Advisory Committee (MAC) submitted its latest report to the UK Government on 12 September 2011 recommending changes to the Shortage Occupation List. The UK Government asked the MAC in March 2011 to consider: “in which occupation(s) or job title(s) skilled to National Qualifications Framework level 4 or above is there a shortage of labour that it would be sensible to fill using labour from outside the European Economic Area”. For an occupation or job title to be placed on the MAC recommended list three tests are considered: • Whether individual occupations or job titles are sufficiently skilled; • Whether there is a shortage of labour within each skilled occupation or job title; and • Whether it is sensible for immigrant labour from outside the European Economic Area to be used to fill the vacancies. We note that the UK Government accepted the MAC recommendations to remove the following occupations covered by our remit from the Shortage Occupation List: • • • Pre-registration and registered pharmacists; Band 7 speech and language therapists; and Health Professions Council (HPC) registered orthoptists. The specific occupations within our remit group included on the Home Office Shortage Occupation List as of 14 November 20112 were: • • Specialist nurses working in operating theatres; Operating department practitioners; 1 Available at: http://www.ukba.homeoffice.gov.uk/sitecontent/documents/aboutus/workingwithus/mac/skilledshortage-sensible/skilled-report.pdf?view=Binary. 2 Available at: http://www.ukba.homeoffice.gov.uk/sitecontent/documents/workingintheuk/ shortageoccupationlistnov11.pdf.
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NHS Pay Review Body Twenty-Sixth Re
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ii © Crown copyright 2012 You may
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Contents Summary of Recommendations
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level since August 1994. We have co
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Chapter 1 - Introduction and Backgr
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in his 20 June 2011 letter that the
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1.21 At the time of submission of t
Page 16 and 17: Chapter 2 - Recruitment, Retention
Page 18 and 19: Table 2.1: Change in NHS workforce
Page 20 and 21: Table 2.3: Leaving and joining rate
Page 22 and 23: Distribution of Staff on Agenda for
Page 24 and 25: Table 2.5: Median gross weekly pay
Page 26 and 27: Figure 2.8: Growth in median gross
Page 28 and 29: Figure 2.9: Estimated pension membe
Page 30 and 31: 3.4 3.5 Figure 3.1: Distribution of
Page 32 and 33: Figure 3.4: Composition of FTE staf
Page 34 and 35: Inflation 3.10 In the context of th
Page 36 and 37: 3.15 The OBR forecast in November 2
Page 38 and 39: 3.22 The Government noted that infl
Page 40 and 41: of components of CPI and RPI over t
Page 42 and 43: Table 3.1: NHS revenue since 2000/0
Page 44 and 45: 3.46 The Department added that rece
Page 46 and 47: surplus on its Departmental Expendi
Page 48 and 49: Evidence from the Parties The Healt
Page 50 and 51: 3.83 We make our assessment of the
Page 52 and 53: staff median earnings across the ec
Page 54 and 55: equired to seek evidence or advice
Page 56 and 57: 4.17 For this report, Unite initial
Page 58 and 59: Table 4.4: Staffing establishments
Page 60 and 61: pre-registration trainee pharmacist
Page 62 and 63: Proposal for a National Recruitment
Page 64 and 65: 4.47 UCATT has drawn to our attenti
Page 68 and 69: • • • • • • Specialist
Page 70 and 71: 5.19 The 2011 NHS Staff Survey in E
Page 72 and 73: Our Comment 5.34 From the evidence
Page 74 and 75: planning process could become fragm
Page 76 and 77: Staff Bodies 5.60 The Staff Side sa
Page 78 and 79: Chapter 6 - A Forward Look 6.1 In t
Page 80: Data and Evidence Requirements 6.13
Page 83 and 84: 74 PROTECT UNTIL PUBLICATION PROTEC
Page 85 and 86: 76 PROTECT UNTIL PUBLICATION 114
Page 89 and 90: 80 PROTECT UNTIL PUBLICATION PROTEC
Page 91 and 92: 82 Deputy First Minister & CabinetS
Page 93 and 94: Appendix B Recommended Agenda For C
Page 95 and 96: C2 C3 86 Figure C3: Composition of
Page 97 and 98: Table C4: Ambulance 88 England FTE
Page 99 and 100: Note that, in years when the number
Page 101 and 102: Table D3: HCHS Paybill per FTE (£)
Page 103 and 104: Table D7: HCHS Workforce (FTE) 1,8
Page 105 and 106: APPENDIX F Previous Reports Of The
Page 107 and 108: APPENDIX G Glossary AfC Agenda for
Page 109 and 110: UK United Kingdom VAT Value Added T
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